Medpedia

So I was speaking with a friend the other day. This is a friend who has recurrent acute pain, not chronic pain, just to be clear. But it’s still relevant to the discussion we started here the other day about how the war on drugs has created this adversarial relationship between doctors and patients.

She’s been trying to get a diagnosis of her pain, which recurs periodically and is pretty severe–severe enough to put her in the bed for several hours when it hits, anyway–for over a year now. After a series of tests revealed lots of little things but no smoking gun, she had to stop the process when her COBRA’d insurance coverage ran out in November. She’ll be covered again in May or June, but until then, she has to carefully manage her access to doctors because of the expense.

So, quite by accident, when she had two root canals in the space of 48 hours and was given tramadol (yep, my old friend) to manage the mouth pain, she found out that the tramadol actually worked on her recurrent acute stomach pain, too. In fact, it’s the only thing that’s ever helped. She’s deathly allergic to morphine and its pure derivatives, so a whole class of pain meds is out of bounds for her. Finding tramadol was for her, as it was for me, a life saver.

Except these pills came from a dentist.

And at the time of our conversation a few days ago, she had experienced two severe bouts of the abdominal pain in a week. And she had exactly four pills left.

She was panicked. That’s why she’d called me. She realized she wasn’t thinking clearly but here’s how she explained what she was thinking:

So, let’s say I go to the doctor. I ask for more tramadol. He says “no.” Because there’s nothing else I can take, he says “take Tylenol” — which we already know doesn’t work for me. And now I’ve got the expense of a doctor visit, no pain relief, and I’ve been labeled a drug seeker.

I get it, and I told her so. Then I suggested she go ahead and make the appointment now, while she had those four pills left, so she could show the doctor she’d carefully rationed the pills and used them only during her flareups. That she was, in fact, not a drug seeker. She agreed that made sense.

This is what it comes down to, dolls. We’re now at the point where we anticipate the suspicion and a lack of medical care.

Doctors, are you listening? We are afraid of you. More specifically, we’ve become afraid to trust you, to seek medical care, for fear that you will jump to unwarranted conclusions.

Now, true, a lot of the responsibility for this falls on us — your patients. And we’re doing what we can to educate ourselves, conquer our fears, and reach out to you.

Are you willing to meet us halfway here?